Factors Influencing Treatment Adherence Research Articles

Factors Influencing Treatment Adherence Among Newly Diagnosed Diabetic Clients of Ledzokuku Krowor Municipal Assembly (Lekma)

The study focused on assessing compliance among newly diagnosed diabetic client in Ledzokuku Krowor Municipal Assembly (LEKMA) Hospital. A descriptive survey design was adopted and 120 diabetic patients were sampled using random sampling techniques. A self-developed questionnaire instrument was the main data collection tool and quantitative analysis was used with the aid of IBM SPSS (v.23). The study found that most of the respondents were of the view that diabetes mellitus was hereditary. It was recorded that all respondents considered hospital-based treatment as effective in treating the condition. About 90 (72.0%) were of the view that of a diabetic patient skipped a dose, he/she was to ignore that dose and wait till the time for the next dose. Moreover, 116 (92.0%) respondents shared with researcher that diabetics were supposed to avoid all fatty foods. All respondents visited the hospital facility on a monthly basis to receive medical-care. Female turn to have adhered more to their medication regimen than the males did, but it was not statistically significant (t=.047, p= .963). Age has negative relationship (r = -.123, p= 533) with their adherence to medication. It was realized that those who had secondary education adhered mostly to diabetic medications followed by tertiary education and primary education attainers respectively. There was a positive relationship (r = .050, p=0.732) between the marital status, occupational status (r = .272, p = .056) of respondents and their adherence status to taking medications. Respondents (40%) disagreed that prescribed medications were fully covered under the National Health Insurance Scheme (NHIS). All of the respondents agreed that finance was a challenge to seeking treatment and medical care for the management of DM. About 40 percent of the respondents feared about side effect of drugs. It was recommended that government should extend the NHIS to cater for DM medications. There was also the need that government subsidized the treatment cost of patients seeking for healthcare with respect to DM

Moderating Effects of Authentic Happiness on the Relationship Between Health-seeking Behaviour and Treatment Adherence Among Patients with Hypertension

Background: Hypertension is a chronic health condition that requires consistent management and adherence to treatment. However, there is a dearth of empirical data on the psychological factors influencing treatment adherence among patients with hypertension in Nigeria. Objectives: To determine the moderating effects of authentic happiness on the relationship between health-seeking behaviour and treatment adherence among patients with hypertension. Methods: The study used a cross-sectional study design. Survey tools comprising items of the Authentic Happiness Scale, Health-seeking Behaviour Scale, Hill-bone Compliance High Blood Pressure Therapy Scale were used to obtain data from two hundred and ninety (290) patients who were selected by purposive sampling and met the study eligibility criteria. Results: Increase in health-seeking behaviour and authentic happiness showed significant effects on adherence to treatment [β1 = 0.241, t = 2.92, p = 0.004; β2 = 0.208, t = 4.80, p = 0.01 respectively]. The interaction between health-seeking behaviour and authentic happiness lacked significant effects on treatment adherence [β3 = 0.003, t = 0.032, p = 0.751]. The analysis of conditional effects revealed that the effects of health seeking behaviour on treatment adherence were significantly differentiated when happiness was low [β = 0.263, t = 2.46, p = 0.015], moderate [β = 0.241, t = 2.92, p = 0.004], or high [β = 0.219, t = 2.02, p = 0.044]. Conclusion: Health-seeking behaviour and authentic happiness are potential explanatory factors for adherence to treatment among patients with hypertension.

Factors Influencing Adherence to the Treatment in Stroke Patients

Adherence in stroke patients for routine re-control is at 50% of total stroke patients. Non-adherence can increase the incidence of recurrent strokes. In stroke recurrence, disability and mortality will increase. This study aimed to determine the factors influencing treatment adherence in stroke patients based on literature studies. This study used a literature study with a sample of 14 journals: Pubmed (n=7), Proquest (n=4), SAGE Journal (n=1), and Science Direct (n=2). The literature study began with identifying data search problems, screening, and quality assessment using JBI cross-sectional studies, cohort studies, qualitative studies, dan Randomized Control trials and analyzed using thematic analysis techniques. As many as 35% of the factors that influence adherence to treatment in stroke patients are beliefs about treatment factors, and social factors and knowledge influence 15% of factors. Economic factors have an estimated percentage of 11% for physical characteristics, and marital status has a rate of 8%; also, age and gender factors have the same presentation, namely 4%. The factor that most influences medication adherence in stroke patients is the belief in the treatment.
 Keywords: factors, influence, treatment adherence, stroke patients

Factors Influencing Treatment Adherence Among Drug-Sensitive Tuberculosis (DS-TB) Patients in Armenia: A Qualitative Study

PurposeDespite the availability of effective treatment, tuberculosis (TB) is still one of the leading causes of mortality around the globe. Poor adherence to treatment challenges TB management both globally and locally. Proper adherence to treatment contributes to successful outcomes and prevents the development of drug-resistant forms of TB.Patients and MethodsWe conducted a qualitative study to identify and describe the factors that facilitated treatment adherence among drug-sensitive TB (DS-TB) patients in Armenia. Sixteen in-depth interviews (IDIs) with former DS-TB patients, two IDIs with family members of former DS-TB patients, and a focus group discussion with healthcare providers who manage DS-TB patients were conducted. The educational and ecological assessment component of the PRECEDE-PROCEED model was applied as a conceptual framework to guide the interview content and data analysis.ResultsFormer patients’ awareness of TB and its treatment, beliefs about TB, trust in TB healthcare providers, and a sense of responsibility were the most common factors that predisposed them to complete the treatment. Support received from providers, family, and friends, a desire to avoid TB-associated stigma, and good tolerance of TB medications were the main reinforcing factors. Enabling factors included a relatively simple regimen of TB treatment and accessibility and affordability of TB services.ConclusionThe findings of the study provide new perspectives on factors that facilitate adherence to long-term therapies, such as TB. Interventions that aim to invoke a patient’s sense of responsibility and positive beliefs about TB as well as engage families might promote the successful completion of treatment.

Towards developing a comprehensive treatment schedule for patients with cerebral palsy: factors influencing patient's adherence to physiotherapy treatment.

This study is aimed to identify factors influencing patient's adherence to treatment in a bid to characterize the extent to which these factors are considered while developing a treatment schedule for patients with cerebral palsy in Nigeria. Descriptive cross-sectional study of physiotherapists involved in the care of patients with cerebral palsy. Factors influencing treatment adherence were assessed using a pre-tested, self-administered questionnaire. Participants were sampled from physiotherapists working at University of Nigeria Teaching Hospital, Enugu State, Nigeria. The data were analyzed using descriptive statistics of percentage and frequencies. A total of fifty three (31 males and 22 females) physiotherapists completed and returned the questionnaire. Participants (84.9%) agreed that patients occasionally forget to meet up with their appointment days; with majority of them agreeing that distance to the clinic and economic factor (cost of treatment and transportation) influence patient's adherence to treatment. Presence/absence of a caregiver and relationship between patients and their physiotherapist are also important factors influencing patient's treatment schedules. Distance to the clinic when compared to other (economic, patient-therapist relationship) factors is the major barrier to patient's adherence to treatment and therefore should be considered while developing treatment schedules for patients with cerebral palsy.

Patient Adherence to Therapy After Myocardial Infarction: A Scoping Review.

BackgroundPatients with myocardial infarction have low adherence to secondary prevention. Patients with acute coronary syndromes usually decide not to take cardiac drugs for 7 days after discharge for various reasons and adherence rates are usually very low. The aim of this scoping review was to identify factors influencing treatment adherence after myocardial infarction and the role of interventions to improve treatment adherence.MethodsTwo electronic databases (PubMed and Web of Science) were systematically searched for relevant published reviews of interventions for adherence after myocardial infarction. Inclusion criteria were study design: randomized control trial, systematic reviews; published in English; sample age ≥18 years. The methodological framework proposed by Arksey & O’Malley was used to guide the review process of the study.ResultsThirteen articles met the inclusion/exclusion criteria. Four of the thirteen studies assessed factors influencing patient adherence to therapy after myocardial infarction, the remaining studies examined various interventions increasing adherence to treatment after myocardial infarction.ConclusionThere is a need to improve adherence of patients to treatment after myocardial infarction. Studies show that the use of modern technologies and communication with the patients by phone improve adherence to treatment.

Factors influencing treatment adherence in hypertension and HIV management in South Africa: A comparative literature review.

Hypertension (HTN) is the most significant risk factor for cardiovascular disease (CVD) in South Africa (SA), with one in three people over the age of 25 suffering from HTN. Whilst human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) are the leading causes of death in South Africa, CVD is in the top 10 causes of death, demonstrating the importance of detecting and controlling blood pressure early on. This study aimed to review adherence factors to antihypertensive medication and antiretroviral therapy (ART) and evaluate the resulting factors influencing adherence discrepancies within the South African population. A comprehensive literature review was carried out. PubMed, ScienceDirect, Cochrane and Embase were searched for English publications between 2000 and 2021. A total of 50 articles covering quantitative and qualitative studies were included. Many studies identified poor adherence levels to antihypertensive treatment, reaching a substandard adherence rate of 41.9%, whilst most studies on the HIV-positive population reported good levels of adherence, with adherence rates of more than 90%. Being of the male gender, advanced age, low socioeconomic status and a low level of education were associated with unsatisfactory adherence rates in both groups. Within the HIV group, more participants had better knowledge concerning the extent of their disease and its required treatments. The results present substandard adherence levels to antihypertensives compared with antiretroviral (ARV) adherence, despite the influence of more non-adherence factors in the HIV group. The authors recommend better adherence counselling for patients with HTN during every clinic visit, regular healthcare worker training and the implementation of ART adherence programmes in patients with hypertension.

Include, Affirm, and Empower: A Paradigm Shift in Cancer Clinical Trials for Sexual and Gender Diverse Populations

Sexual and gender diverse (SGD) individuals have unique lived experiences across the lifespan that contribute to health disparities and influence cancer risk and outcomes. Biopsychosocial factors contribute to trauma and medical mistrust with suboptimal engagement with healthcare and cancer-preventive screenings. These factors contribute to cancer disparities among SGD people. A lack of inclusive and affirming practices within cancer clinical trials also contributes to this problem. Dismantling exclusionary research practices requires strategic action. We advocate for sexual orientation and gender identity (SOGI) data collection as well as thoughtful design and conduct of clinical trials that consider the role of intersectionality and minority stress. Exploring SGD cancer patients’ lived experiences and medical histories in a sensitive and affirming manner will help us learn about factors influencing treatment adherence and prognosis. The current manuscript outlines a paradigm shift in the conduct of clinical trials from early conceptualization through dissemination and implementation in order toinclude, affirm, and empowerSGD people with cancer. We provide an overview of culturally responsive practices that should be implemented at each phase of the research process. These enhancements to conventional trial procedures will promote the long-term goal of improving the safety and efficacy of cancer treatments for SGD patients. We also discuss methods for SGD community engagement, research personnel training, and considerations for working with SGD people in industry-funded clinical trials. Advancing clinical and research competencies along these guidelines are fundamental to promoting the inherent value of SGD patients’ lives and more equitable outcomes across the cancer care continuum.

A cross-sectional study of factors associated with anti-depressant medication adherence in women attending an out patient psychiatry department

Introduction: Treatment adherence and illness may not be related only by the severity of the illness but by so many other factors which impact on seeking and continuing treatment; yet severity of the illness will be one of the major factors influencing treatment adherence. Methods: Female patients attending the psychiatric OPD, diagnosed with depression as per ICD-10 guidelines and provided informed consent participated in this questionnaire-based study. A total of 135 patients who attended the OPD in 9 months were assessed for the severity of depression and medication adherence by administering scales to assess the severity of depression and medication adherence was assessed by questioning about the drug taking and hospital attending behaviour. Out of this, thirty-one were attending for the first episode and hence were excluded from the analysis. Results: Out of the 104 female patients diagnosed with depression of more than one episode, 44 (42.3%) had mild depression, 52 (50%) had moderate depression and 8 (7.7%) had severe depression. Twenty-nine women (27.9%) were on medications and 75 (72.1%) women were not taking their medications. While greater proportion of women with mild depression were adherent to medication (51.7%), more women with moderate depression didn’t adhere to medication (54.7%), even though such difference was statistically not significant. Older age, having a paid work and married status were significantly associated with medication (antidepressants) adherence. Conclusions: Our results indicate that medication adherence is associated with factors other than severity of depression. Work and marital status played a significant role in determining the adherence to antidepressant medications among women.

A systematic review of factors influencing treatment adherence in chronic inflammatory skin disease - strategies for optimizing treatment outcome.

Adherence describes how a patient follows a medical regime recommended by a healthcare provider. Poor treatment adherence represents a complex and challenging problem of international healthcare systems, as it has a substantial impact on clinical outcomes and patient safety and constitutes an important financial burden. Since it is one of the mostcommon causes of treatment failure, it is extremely important for physicians to reliably distinguish between non-adherence and non-response. This systematic review aims to summarize the current literature on treatment adherence in dermatology, focusing on chronic inflammatory skin diseases such as psoriasis, atopic dermatitis and acne. A systematic literature search was performed using the PubMed Database, including articles from 2008 to 2018. Low treatment adherence is a multidimensional phenomenon defined by the interplay of numerous factors and should under no circumstances be considered as the patient's fault alone. Factors influencing treatment adherence in dermatology include patient characteristics and beliefs, treatment efficacy and duration, administration routes, disease chronicity and the disease itself. Moreover, the quality of the physician-patient relationship including physician-time available for the patient plays an important role. Understanding patients' adherence patterns and the main drivers of non-adherence creates opportunities to improve adherence in the future. Strategies to increase treatment adherence range from reminder programs to simplifying prescriptions or educational interventions. Absolute adherence to treatment may not be realistically achievable, but efforts need to be made to raise awareness in order to maximize adherence as far as possible.

Assessment of adherence to therapy and exploring of barriers and facilitators in HIV positive patients in Tabriz-Iran: a mixed method study protocol

BackgroundAdherence to therapy is a key predictor of the success of human immunodeficiency virus (HIV) treatment. There is limited information available from Iran about that and there is a need for more knowledge about factors influencing treatment adherence. The aim of this study is to examine adherence levels and to explore patients’ views about barriers and facilitators to HIV treatment adherence.MethodsThis mixed-method study with the sequential explanatory design has two phases. The first phase (quantitative phase) is a cross- sectional study to assess the in Tabriz, the sixth large city of Iran. A convenience sampling method will be used to select 150 HIV positive patients who visit health centers in Tabriz. The second phase is a qualitative study designed to explore the HIV positive patients’ views of barriers and facilitators that can affect their adherence to therapy. In this phase, purposive sampling and in-depth individual interviews will be conducted for data collection. The conventional content analysis approach will be employed for data analysis. In addition to literature review and nominal group technique, the findings of the qualitative and quantitative phases, will be used to recommend some strategies to support adherence to therapy in HIV positive patients.DiscussionThis is the first study looking into adherence to therapy and exploring of factors influencing in HIV positive patients which will be performed via a mixed-method approach, aiming to develop health practices improvement strategies. It is worth noting that there is no strategic guideline in Iran’s health system for improvement of treatment adherence in HIV positive patients. Health professionals and policy makers can be aware of factors influencing HIV treatment adherence. Therefore, it is hoped that the strategy proposed in the current study can lead to improvements their ability to treatment adherence.

Investigation on current status of home oxygen therapy and factors influencing treatment adherence among patients with chronic obstructive pulmonary disease

Investigation on current status of home oxygen therapy and factors influencing treatment adherence among patients with chronic obstructive pulmonary disease

Influence of treatment adherence on the progression of primary open-angle glaucoma in clinical setting

To study the influence of treatment adherence in patients receiving preservative-free and preserved medications on the progression of primary open-angle glaucoma (POAG). This prospective multicenter non-interventional study was conducted in clinical setting and included 504 patients with primary open-angle glaucoma receiving drug therapy; 51 ophthalmologist was involved in the management of patients' diaries. The percentage of patients who did not reach target IOP was three times lower in the group with high adherence, in comparison to patients with medium and low adherence (7% against 22%, respectively). Development of side effects was one of the factors influencing treatment adherence, their rates and expressiveness were much lower in the preservative-free group compared with the group receiving preserved medication (13.9% against 35.4%). The rate of patients who did not reach target IOP was two times lower in the group of preservative-free medication (10% against 21%). The study confirms that preservative-free glaucoma medication promotes higher adherence to treatment in clinical setting predominantly due to the reduction of quantity and severity of side effects leading to treatment gaps, which results in increased effectiveness and better stabilization of glaucoma.

Chronic conditions in adolescents.

The health problems related to the nervous system are on rise in young infants leading to high mortality amongst this age group. A chronic medical condition (CC) is present in this age group to the tune of 10–20%. We searched the electronic database PubMed for pre-clinical as well as clinical controlled trials reporting variable chronic conditions especially in pediatric patients. Most of these reports revealed that type 1 diabetes mellitus is the most common CC in young infants. In female patients, metabolic control is often disturbed during CC in this age group. Poor metabolism regulation often results in long-term complications, including cognitive disorders. In cognitive disorders, memory loss and learning problems are the most among adolescents. Executive problems are observed to be associated with low physical activities. The review article concludes that knowledge about factors influencing treatment adherence is crucial in chronically ill infants. Further, we should focus on protective factors in order to prevent health risk behavior.

Study of Factors Influencing Treatment Adherence in Childhood Attention Deficit Hyperactivity Disorder in a Tertiary Healthcare Facility.

Background:Attention deficit hyperactivity disorder (ADHD) is a common childhood mental health disorder. Treatment has shown to improve both short and long-term prognosis. Hence, study of factors leading to nonadherence is undertaken.Objective:The objective was to know the rate of nonadherence and factors affecting nonadherence.Setting and Design:Cross-sectional follow-up study at child guidance clinic in a tertiary health care facility.Materials and Methods:Forty children with a diagnosis of ADHD initiated on treatment either combined or nonpharmacological were followed-up and checked for nonadherence. Factors leading on to nonadherence were assessed.Statistics:By SPSS 16.0 and Epi info.Results:Rate of nonadherence was 62.5%. 75.7% of nonadherence contributed by social factors. Delivery by caesarean predicted nonadherence. Age of diagnosis and baseline severity did not have an effect on adherence.Conclusion:Rate of nonadherence to treatment was low compared to other Indian studies. Social factors mainly implicated for nonadherence. An effort for education and information of the society about ADHD is needed.

Factors Influencing Treatment Adherence and Discontinuation in Women with Breast Cancer

SUMMARY Although all aspects of breast cancer care rely to some extent on patient behaviors, the endocrine therapies, which are orally administered at home, are the most impacted by nonadherence and nonpersistence. A variety of issues can interfere with a breast cancer patient's adherence and persistence including the following: sociodemographic factors; healthcare team and system-related factors (such as inadequate visit time and poor medication distribution services); condition-related factors (such as prognosis); therapy-related factors (such as side effects); and patient-related factors (such as attitudes, beliefs, perceptions, and expectations). In our review, we describe evidence regarding the most powerful factors mediating adherence and persistence in breast cancer patients, and explore potential interventions to reduce nonadherence and nonpersistence, primarily based on data in patients taking adjuvant endocrine therapy.

Treatment Adherence among Tuberculosis and Human Immuno Deficiency Virus Coinfected Patients in Ginnir Referral Hospital

Tuberculosis is a major public health problem in Ethiopia, and a high number of TB patients are co-infected with HIV. There is a need for more knowledge about factors influencing treatment adherence in co-infected patients on concomitant treatment. The objective of this study is to assess treatment adherence among TB/HIV co infected patients in Ginnir referral hospital from March - April 2013. Institution based cross sectional study design was used to collect, analyze and summarize data from TB/HIV co-infected patients. The data was sorted manually and scientific calculator was used to compile and express in table and graphs. Descriptive statistics like frequencies, mean and median were used to analyze the data. Prior to data collection, permission request was obtained from Madawalabu University, Goba campus and it was submitted to Ginnir referral hospital’s medical director. Respondents were told about the objective of this study, reassured for confidentiality and asked for consent. The results shown among the 53 TB/HIV co- infected patients, 11(20.7%) had missed taking both ARV and anti TB drugs at least once. Of these, 4 (36.4%) had missed the ARV treatment while remaining 7(63.6%) of them missed the anti TB medication. The result showed that, the main reason for missing the drugs was forgetting taking medication 6(54.6%). It can be concluded that the level of non adherence is relatively high and the main reason behind was forgetting distance from health institution and income related problems. Intervention s to reduce it need to be instituted such as adherence educations should have to be given for the patients to take the treatment by the recommended schedule and also family members and supporters should have to be told to remind and follow them carefully. On the other hand bringing the health service nearby might alleviate the problem of distance. In order to deal with the income related problems, Ginnir referral hospital should have to work in collaboration with NGOs and other fund raising institutions.

Analysis of reasons for low adherence to antiepileptic therapy in patients with symptomatic epilepsy

Objective: to study the major factors that influence treatment adherence. Patients and methods. One hundred patients aged 20 to 68 years (mean age 42.9±3.0 years for women and 43.3±5.0 years for men) diagnosed with a ≥3-year history of symptomatic epilepsy were screened. The minimal and maximal durations of the disease were 5 and 59 years, respectively (mean 20.8±3.9 years). Results and discussion. There was a female preponderance in the treatment adherence group. The patients who had secondary special education were unemployed, disabled, and single were in both comparison groups. These data are indicative of social stigmatization in epileptic patients. Patients with severe epilepsy on multiple drug therapy were prevalent. Neuropsychological testing revealed higher levels of anxiety and depression among those who were non-adherent to therapy. Conclusion. The sex, age, and social characteristics (education level, disability) of patients with epilepsy and its clinical picture, neurological symptoms and changes were ascertained by magnetic resonance imaging had no significant impact on therapy adherence. The factors influencing treatment adherence should include multiple drug therapy (co-administration of two or three drugs) and the high frequency of drug use, which is more frequently observed in patients with severe treatment-resistant epilepsy. Anxiety and depressive disorders in epileptic patients resulted in impaired compliance with anticonvulsant therapy.

Disparity in perceptions of disease characteristics, treatment effectiveness, and factors influencing treatment adherence between physicians and patients with myelodysplastic syndromes

Previous studies have suggested that many patients with myelodysplastic syndromes (MDS) have an incomplete understanding of their disease, which may influence adherence to prescribed regimens and outcomes. To better understand physician and patient perceptions about MDS and MDS therapy, the authors conducted 2 surveys in February 2012: 1 for patients with MDS and 1 for health care professionals (HCPs) who cared for patients with MDS. Patient and HCP surveys consisted of 57 and 49 questions, respectively, assessing understanding of MDS, perceptions of specific treatments, barriers to treatment adherence, and treatment experience. In total, 477 complete patient responses and 120 complete HCP responses were received. Among patient responders, 63% were aged ≥60 years, and 42% had received at least 1 disease-modifying therapy. Of the 61 physician responders, 57% practiced in an academic setting, and 43% practiced in the community; 71% of the 59 nonphysician HCPs worked in the community setting. Only 10% of patients agreed that MDS represented "cancer" compared with 59% of physicians and 46% of nonphysician HCPs (P < .001). Only 29% of patients reported that MDS was ever "curable" compared with 52% of physicians (P < .001). Physicians viewed the potential benefits of active therapy as greater than patients, but patients perceived the actual treatment experience more positively than physicians and differed from physicians in perceived reasons for stopping therapy. Physicians, nonphysician HCPs, and patients with MDS have disparate views of MDS characteristics and the value and limitations of treatments for MDS. Improved communication and education may increase understanding and achieve better treatment adherence and patient outcomes.

Inter‐rater reliability of the Pediatric Transplant Rating Instrument (P‐TRI): Challenges to reliably identifying adherence risk factors during pediatric pre‐transplant evaluations

The purpose of this study was to assess the inter-rater reliability of the P-TRI, a 17-item instrument developed to identify risk factors associated with poor treatment adherence in pediatric solid organ transplant candidates. Because factors influencing treatment adherence may vary with age, the 89 subject samples were divided into pre-adolescent (0-11 yr) and adolescent (12-19 yr) groups. Each subject received two independent P-TRI ratings based on pretransplant psychosocial assessments separately conducted by a PSYC and a SWTC. Inter-rater reliability was assessed using the delta statistic. Overall, agreement was higher in the pre-adolescent group, with delta>0.70 for five items and delta<0.30 for two items. For the adolescent group, one item had a delta>0.70 and seven items had a delta<0.30. Overall, PSYC P-TRI ratings indicated fewer areas of concern on items assessing family dynamics compared with SWTC P-TRI ratings, whereas the reverse was true for items related to psychiatric history. Results highlight the challenges of conducting a reliable pretransplant assessment of adherence-related risk factors and suggest the need for revisions to the P-TRI prior to its use in clinical practice.